Nicolle Fletcher of Conway does not want to be a midwife, an obstetrician or a nurse — she just wants to be the best doula she can be.
Yes, a doula.
Fletcher, who is married and has three children, said doulas work with newly pregnant women, laboring women and mothers after they give birth to provide education and support.
“We do provide that comfort and that emotional support for women who are going through a pretty intense transformation,” she said.
The word doula originates from a Greek word meaning “a woman who serves.”
“A midwife is the OB-GYN of home births. A doula is a supplement or complement to both of those, whether in the hospital or at home,” Fletcher said.
Wednesday is World Doula Day, part of World Doula Week. That day was chosen because it is the spring equinox, which represents the return of fertility in countless cultures, according to worlddoulaweek.com.
Fletcher, 40, became a certified doula in 2010, which took a year. She joked about becoming a midwife when a friend had a home birth, and Fletcher’s husband, Phillip, brought home a midwife’s business card.
After meeting with that midwife, Fletcher said she learned it took three to five years to become a midwife and one year to become a doula.
Fletcher started her own company, Birth by Design Birth and Postpartum Services, in 2012. She had a network of six doulas, which has grown to 17. Their client list is at about 70 in Arkansas, which includes Conway, Russellville, North Little Rock, Little Rock, Hot Springs, Jacksonville and other communities.
To celebrate World Doula Week, from 9 a.m. to 5 p.m. March 27, people may drop by the Conway office of Birth by Design, 813 Parkway St., to visit with some of the doulas. Information about other events is available on the organization’s Facebook page Birth by Design Birth and Postpartum Services.
Many physicians are welcoming of doulas, she said.
“Support by doctors and nurses has always been important; that’s something we strive really hard to do and have done, really, an amazing job at that,” she said.
“Having a doula doesn’t mean we are dismissive of your doctor or dismissive of your nurse,” Fletcher said.
She said doulas have a wealth of knowledge and can help provide emotional support, as well as help women get their babies in position for the birth to prevent cesarean sections.
Fletcher said the American Congress of Obstetricians and Gynecologists reported that a study showed that “doulas are the most effective, yet underused, tool in C-section prevention; so that’s a big deal.”
“Hospitals and doctors are trying to reduce cesarean rates,” Fletcher said. “I think there needs to be a closer look at doula support.
“We optimize fetal positioning. We help momma move to move their babies to be properly aligned for birth.”
The optimum time to hire a doula is between 12 and 16 weeks of gestation, Fletcher said. She said doulas don’t make any plans to leave home when their clients are close to their due dates. When the client goes into labor, she calls her doula, no matter the time of day or night.
“A doula can be support in any birth environment or circumstance, whether you’re a single mom or have a husband, whether your mom is going to be there, or your mother-in-law, or they all are going to be there — whether you’re having [the baby] at home or in the hospital,” Fletcher said.
She compared a doula to a personal trainer who encourages a client to help him achieve his goals, or a wedding planner who makes a couple’s big day go more smoothly.
“I want to make the birth as enjoyable for the mom and dad as possible,” Fletcher said. She recalled one birth at Conway Regional Medical Center in which she was participating as a doula.
Sarah Flippo of Russellville said she and her husband, J.D., hired Fletcher for the birth of their second son, Rhett. He was born at Conway Regional Medical Center; her first son was born at a different
hospital.
“We don’t have any family in town, and when my oldest was born, it was a fairly traumatic birth, so we chose to have a doula the second go-round,” she said. “We were kind of late to the game; I want to say 30 weeks, maybe.”
Flippo said it was the right decision.
“[Fletcher] was great, and we loved her. We met her several times; she came to at least one or two doctor’s appointments,” Flippo said. “We just kind of talked through everything, what had gone on with my older son’s birth and everything. It was more what we didn’t want to happen rather than a set-in-stone birth plan. You can’t plan it.”
Fletcher said they “had a blast” while waiting for
Flippo’s son to be born. Fletcher said she teaches a dancing-for-birth class, and they wear coin skirts.
“It’s a combination of belly dancing … it’s about fetal positioning,” Fletcher said.
Flippo laughed when she recalled the episode.
“My sister is hilarious and funny, so at some point, everybody ended up with coin skirts dancing freely; of course, Anna’s ended up on her head,” Flippo said. “They danced around; I had mine around my waist where it should be.”
Although Flippo was on the brink of having to have a C-section, it was avoided. She credited both her obstetrician, Dr. Brandie Martin, and Fletcher.
“Barely anything went according to plan, but because of our relationship with Nicolle and her relationship with the doctor and the facility, everything was just awesome. There was just so much communication,
and there was so much teamwork and support,” Flippo said.
Her son is now 8 months old.
Postpartum doulas are available, too, to support the mother when she brings the baby home. Doulas come to the home in two- to four-hour increments to help balance the schedule for the new baby, make sure the mother is eating correctly, etc., and they will accompany the mother to doctor’s visits.
Fletcher said she just wants women to know their options.
“I do not want women birthing in ignorance,” she said. Even if a woman has “the best OB-GYN in the world,” she may have unanswered questions, Fletcher said.
“Most women say when they thought they couldn’t do it anymore, or they were just done, the doula either had the right trick, the right words or the right look that helped them keep going,” Fletcher said.
Women can fill out a form on the website birthbydesigndoulas.com.
“You’ll get a phone call or email for a 30-minute free consultation about doula support and our services,” she said.
The $1,000 service includes six prenatal visits, a lactation and postpartum planning appointment, 24-hour support, and two visits after delivery from a lactation and birth doula. The business also offers placenta encapsulation for an extra $200. A doula will go to the hospital to get the placenta after a woman gives birth, grind it into powder and put it in pill form for the woman to take. Fletcher said there are many health benefits to ingesting the placenta, including helping prevent postpartum depression, and boosting energy and breast-milk supply.
Also, six weeks of childbirth classes are available for $200.
Fletcher said doulas help make the birthing process, which she describes as designed by God, go as smoothly as possible.
“We do go by the mantra that birth is better together. We do really believe birth — with your doctor, your doula, your nurse — really is to work together as a team and fill in the holes and the pockets that may be missing from standard maternity care,” she said.
Senior writer Tammy Keith can be reached at (501) 327-0370 or tkeith@arkansasonline.com.